Trocar system having a drive

ABSTRACT

Systems and methods for using a trocar system are disclosed. The system generally includes a handle having a first end a second end, a trocar disposed adjacent the first end of the handle, cannulas disposed on the trocar, and a drive system. The drive system is disposed for forward movement of the cannulas in a longitudinal direction away from the second end of the handle.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application claims priority to U.S. Provisional PatentApplication No. 61/550,012 filed on Oct. 21, 2011, which is herebyincorporated by reference in its entirety.

FIELD

This disclosure generally relates to trocar systems and, morespecifically, to trocar systems operable to move a cannula along atrocar.

BACKGROUND

Incisions are formed in a patient's body (e.g., in the eye) in a varietyof surgical procedures. Typically, cannulas are inserted into theseincisions to keep the incision from closing. Other surgical implementsmay then be inserted through the cannula into the patient's body afterremoval of the trocar.

These previous systems are time-consuming, and costly and thereforeunsatisfactory. Accordingly, an improved trocar system is needed.

This Background section is intended to introduce the reader to variousaspects of art that may be related to various aspects of the presentdisclosure, which are described and/or claimed below. This discussion isbelieved to be helpful in providing the reader with backgroundinformation to facilitate a better understanding of the various aspectsof the present disclosure. Accordingly, it should be understood thatthese statements are to be read in this light, and not as admissions ofprior art.

BRIEF SUMMARY

One aspect is a trocar system comprising a handle having a first end anda second end, a trocar disposed adjacent the second end of the handle,and cannulas disposed on the trocar. The system also comprises a drivesystem disposed for forward movement of the cannulas in a longitudinaldirection away from the second end of the handle.

Another aspect is a trocar system comprising a handle, a drive member, apawl, a plunger, a trocar, and a cannula. The handle has a hollowinterior section and a first end and a second end. The drive member ispositioned within the hollow interior section and has a first end and asecond end. The drive member has teeth and is configured for movement ina longitudinal direction. The pawl is positioned within the hollowinterior section and is disposed to selectively engage one of the teethand prevent rearward movement of the drive member in the longitudinaldirection. The plunger has a first end a second end disposed toselectively engage one of the teeth to move the drive member forward inthe longitudinal direction. The trocar is disposed adjacent the secondend of the handle and the cannula has a central opening for receivingthe trocar. The first end of the drive member is disposed relative tothe cannula such that forward movement of the drive member by theplunger results in forward movement of the cannula in the longitudinaldirection.

Still another aspect is a trocar system comprising a handle, a drivemember, a pawl, a plunger, and a trocar. The handle has a hollowinterior section and a first end and a second end. The drive member ispositioned within the hollow interior section and has a first end and asecond end. The drive member also has a plurality of teeth. The pawl ispositioned within the hollow interior section and is formed from aresilient material. The pawl is disposed to selectively engage one ofthe teeth and prevent rearward movement of the drive member in thelongitudinal direction. The plunger has a first end and a second end.The second end of the plunger is formed from a resilient material and isdisposed to selectively engage one of the teeth to move the drive memberforward in the longitudinal direction. The trocar is disposed adjacentthe first end of the handle. The first end of the drive member isconfigured for connection to a cannula disposed on the trocar such thatforward movement of the drive member by the plunger results in forwardmovement of the cannula in the longitudinal direction.

Yet another aspect is a method of using a trocar system to insert acannula into an incision formed in a portion of a patient's body. Thetrocar system comprises a handle, a drive member, a pawl, a plunger, atrocar, and a cannula. The cannula has a central opening sized toreceive the trocar. The method comprises inserting the trocar into anincision in a portion of the patient's body. The cannula is theninserted into the incision and the cannula is disposed between theincision and the trocar. The plunger is then depressed and depression ofthe plunger engages a tooth on the drive member and moves the drivemember forward in a longitudinal direction. Forward movement of thedrive member results in forward movement of the cannula to a positionadjacent an end of the handle.

Various refinements exist of the features noted in relation to theabove-mentioned aspects. Further features may also be incorporated inthe above-mentioned aspects as well. These refinements and additionalfeatures may exist individually or in any combination. For instance,various features discussed below in relation to any of the illustratedembodiments may be incorporated into any of the above-described aspects,alone or in any combination.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective of one embodiment of a trocar system;

FIG. 2 is a side view of the system of FIG. 1;

FIG. 3 is cross-sectional view of the system of FIG. 1 taken along the3-3 line of FIG. 2;

FIG. 4 is an front view of the system of FIG. 1;

FIG. 5 is a rear view of the system of FIG. 1;

FIG. 6 is an enlarged view of one of the cannulas of the system of FIG.1; and

FIG. 7 is an exploded view of the system of FIG. 1.

Like reference symbols in the various drawings indicate like elements.

DETAILED DESCRIPTION

The embodiments described herein generally relate to trocar systems thatare operable to move a cannula disposed on one end of a trocar when auser depresses a plunger. Such systems may be used in various surgicalprocedures such as ophthalmic procedures, and in particular,intra-ocular ophthalmic procedures for vitreo-retinal surgery. Thus,while reference is made herein to use of the system in ophthalmicprocedures, it should be understood that the system can also be used inother surgical procedures.

An example trocar system is generally indicated by reference numeral 100in FIG. 1. The system 100 of this embodiment includes a trocar 110, ahandle 120, three cannulas 130, and a plunger 140. Other components ofthe system 100 are discussed in greater detail below.

Typical trocar 110 configurations include hypodermic needles,lancet-shaped needles, stiletto blades, saber-tipped blades, and beveledrods. Furthermore, in some systems the trocar 110 is a blunt insertiondevice that is used to insert the cannula 130 into an incision formed byanother sharp or pointed object.

As best seen in the cross-sectional view of FIG. 3 and exploded view ofFIG. 7, the system 100 also includes a drive system 160 comprising adrive member 162, a pawl 180, the plunger 140, a tube 188, a firstspring 190, and a second spring 192.

As shown in FIGS. 1-3, the trocar 110 has a first end 112 having a sharppoint for piercing a portion of a patient's body (e.g., a patient's eye)and forming an incision therein. An opposing second end 114, seen bestin FIG. 3, is disposed away from the first end 112 of the trocar 110 andis received within the handle 120. The second end 114 is connected tothe handle 120 by a wire lock 116, although other embodiments may usedifferent types of fastening systems (e.g., other mechanical fastenersand/or adhesives).

As shown in FIG. 1, the handle 120 has a first end 122 and an opposingsecond end 124 opposite from the first end. A first opening 126 isformed adjacent the first end 122 and a second opening 128 is likewiseformed adjacent the second end 124. The handle also has a hollowinterior section 125 (FIG. 3) and an outer surface 127, a portion ofwhich receives an ergonomic rubberized grip 129 (FIGS. 1 and 3). Thegrip 129 aids a user grasping the handle 120 and provides a comfortablegripping surface.

Cannulas 130, one of which is shown in greater detail in FIG. 6, have acentral opening 132 sized to receive the trocar 110. That is, thecentral opening 132 has a diameter slightly larger than a diameter ofthe trocar 110. In use, the cannula 130 is positioned within theincision formed by the first end 112 of the trocar 110. The cannula 130keeps the incision from collapsing or closing after removal of thetrocar 110 so that other surgical implements can be inserted through thecentral opening 132 and into the patient's body.

In the example embodiment, three cannulas 130 are positioned on thetrocar 110, although in other embodiments different numbers of cannulasmay be used. Moreover, in the example embodiment all of the cannulas 130except one are positioned on the trocar such that they are disposed in arecess 118 in the second end 124 of the handle 120. Only the mostproximal cannula protrudes from the second end 124 of the handle 120.Retention members (e.g., crush ribs) can be positioned in the recess 118to prevent unintentional movement of the cannulas 130 from the recess.

The plunger 140, broadly an actuating member, is positioned adjacent thefirst end 122 of the handle 120 and a portion 142 of the plunger isreceived within the hollow interior section of the handle. As shown inFIG. 3, the plunger 140 travels through the first opening 126 of thehandle 120 and keyway 150. The plunger 140 has a first end 144 with asclera marker 146 and a second end 148 that is generally configured tomove the drive member 162 forward in a longitudinal direction L towardsthe second end 124 of the handle. In this embodiment, the sclera marker146 is made integral with the plunger, but the marker may have otherconfigurations in other embodiments

The plunger 140 has a keyway 150 (FIG. 3) disposed adjacent its firstend 144 that couples to the first end 122 of the handle 120 to limit thedistance which plunger can be depressed (referred to as a depressiondistance). Portion 142 is fitted to keyway 150 to prevent rotationalmovement within handle 120. In some embodiments, the plunger 140 is notused and instead the drive member 162 is extended such that it protrudesfrom the first end 122 of the handle 120. The user thereby actuates thedrive member 120 directly, rather than indirectly with the plunger 140.

In still other embodiments, the actuating member can be disposed fordepression by a user in a direction other than the longitudinaldirection L to move the drive member 162 forward. For example, theactuating member may be disposed for depression in a direction radial tothe longitudinal direction L to move the drive member 162 forward in thelongitudinal direction. The actuating member and/or drive member 162 mayalso rotate when moved in the longitudinal direction L. For example, theactuating member and/or drive member 162 may be components in a screwand/or worm drive.

The drive member 162 (FIG. 3) is elongate and has a first end 164disposed opposite from a second end 166. The drive member 162 ispositioned within the hollow interior section 125 of the handle 120 andhas a plurality of teeth 168 disposed on its surface, each of which havea sloped portion 170 and a backside 172. In the example embodiment,there are five teeth 168 while other embodiments may use a drive memberhaving more or less teeth. The second end 148 of the plunger 140 isdisposed to selectively engage teeth 168 to move the drive member 162forward in the longitudinal direction L. This forward movement istowards the first end 112 of the trocar 110.

The pawl 180 (FIG. 3), broadly a detent mechanism, is positioned withinthe hollow interior section 125 and is disposed to selectively engageteeth 168 to prevent rearward movement of the drive member 162 in thelongitudinal direction L. The pawl 180 also has a sloped portion 182that is complementary to the sloped portions 170 of the teeth 168. Thepawl 180 deflects away from the drive member 162 upon contact of itssloped portion 182 with one of the sloped portions 170 of the teeth 168.This deflection permits the teeth 168 to move through the pawl 180 asthe plunger 140 moves the drive member 162 forward in the longitudinaldirection L.

The pawl 180 includes a resilient material so that it returns to itsundeflected position after the tooth 168 has moved far enough forward inthe longitudinal direction L where its sloped portion 170 is not incontact with the sloped portion 182 of the pawl 180. The pawl 180 thenengages the backside 172 of the tooth 168 upon any attempted rearwardmovement of the drive member 162. The pawl 180 and the backside 172 ofthe tooth 168 are in locking engagement as a result of this attemptedrearward movement such that the pawl cannot be deflected by the backsideof the tooth. Accordingly, the pawl 180 prevents rearward movement ofthe drive member 162.

In other embodiments, the detent mechanism is a member biased in adirection radial to the longitudinal direction L. The member is disposedfor selectively engaging indentations or other indexing features on thedrive member 162 to selectively limit rearward movement of the drivemember.

A portion 152 of the plunger 140 is disposed to deflect away from theteeth 168 upon contact with their sloped portions 170. The portion 152includes a resilient material such that it returns to its undeflectedposition after the teeth 168 pass through. This deflection permitsrearward movement of the plunger 140 with respect to the drive member162. The second end 148 of the plunger 140 engages the backside 172 ofone of the teeth 168 when depressed by a user. This engagement resultsin forward movement of the drive member 162 in the longitudinaldirection L.

A first spring 190 is positioned within the hollow interior section 125of the handle 120. It is connected to the plunger 140 and a portion ofthe handle 120 and biases the plunger against forward movement in thelongitudinal direction L. This spring 190 is a compression spring in theexample embodiment, although in other embodiments the spring may be anysuitable type of spring or biasing device.

A second spring 192 is also positioned within the hollow interiorsection 125 of the handle 120. It is connected to the drive member 162and a portion of the handle and biases the drive member against forwardmovement in the longitudinal direction L. This spring 192 is acompression spring in the example embodiment, although in otherembodiments the spring may be any suitable type of spring or biasingdevice.

As shown in FIG. 3, a tube 188 connects the drive member 162 to the mostrearward cannula (i.e., the cannula positioned nearest the drivemember). Forward movement of the drive member 162 results in forwardmovement of the cannula 130 connected to the tube 188. A first end 194of the tube 188 is connected to the most rearward cannula 130. A secondend 196 of the tube 188 is connected to the drive member 162. In theexample embodiment, the second end 196 of the drive member 162 isreceived within a recess formed in the drive member adjacent its firstend 164.

Forward movement of the most rearward cannula 130 results in forwardmovement of the other cannulas positioned adjacent to it on the trocar110. In other embodiments, a tube is not used and instead the mostrearward cannula 130 is directly connected to the drive member 162without any intervening member (e.g., the tube). Alternatively, anotherstructure or connection device may be used to connect the drive member162 to the cannulas 130.

Cannulas 130 are first positioned on the trocar 110 prior to usage ofthe system 100. In the example embodiment, three cannulas 130 are usedwhile in other embodiments more or less cannulas can be used.

In use, generally, the user depresses the plunger 140 to move thecannulas 130 forward in the longitudinal direction L along the trocar110. Depression of the plunger 140 until the keyway 150 prevents furthertravel results in the movement of the cannulas 130 such that anothercannula protrudes from the handle 120.

In the example embodiment, the first end 112 of the trocar 110 is usedto pierce a portion of a patient's body (e.g., the patient's eye) andcut an incision therein. In other embodiments, the piercing action canbe performed by a separate sharp or pointed object and the trocar 110 isa blunt insertion device onto which the cannulas 130 are installed.

The trocar 110 is then inserted into the patient's body through thisincision. As described in greater detail below, the drive system 160 isthen used to move the cannulas 130 forward in the longitudinal directionL. In other embodiments, the drive system 160 is used to move thecannulas 130 forward prior to insertion of the trocar 110 into theincision or usage of the trocar to form the incision.

The second end 148 of the plunger 140 is then depressed by the userresulting in engagement of the drive member 162 by the first end 144 ofthe plunger. The first end 144 of the plunger 140 engages the backside172 of one of the teeth 168 and thus forward motion of the plungerresults in likewise forward movement of the drive member 162. As thedrive member 162 moves forward in the longitudinal direction L, thesloped portion 170 of one of the teeth 168 deflects the sloped portion182 of the pawl 180. This deflection permits the tooth 168 to movethrough the pawl 180.

The forward movement of the drive member 162 in turn results in forwardmovement of the cannulas 130 disposed on the trocar 110. As describedabove, the tube 188 connects the most rearward cannula 130 to the drivemember 162 in the example embodiment. The depression of the plunger 140until the keyway 150 prevents further travel of the plunger results inmoving the cannulas 130 a distance such that another cannula protrudesfrom the second end 124 of the handle 120. The representation of FIG. 3depicts the system 100 after it the plunger 140 has been depressed tomove the cannulas 130 forward such that one cannula protrudes from thesecond opening 128 in the second end 124 of the handle 120.

The user then releases the plunger 140 and the first spring 190 returnsthe plunger to its initial, undepressed position (as shown in FIG. 3).As the plunger 140 returns to its initial position, the portion 152 ofthe plunger against its second end 148 is deflected by contact with thesloped portion 170 of the tooth 168. This deflection permits rearwardmovement of the plunger 140.

The pawl 180 prevents rearward movement of the drive member by engagingthe backside 172 of the tooth 168. After the sloped portion 170 of thetooth 168 travels through the pawl 180, the pawl returns to itsundeflected position. The pawl 180 and the backside 172 of the tooth 168are in locking engagement such that when engaged the pawl cannot bedeflected by the backside of the tooth. In this undeflected position,the pawl 180 prevents rearward movement of the drive member 162. Thesecond spring 192 biases the drive member 162 against forward movementto prevent unintended forward movement. The second spring 192 alsoensures that the backside 172 of the tooth 168 remains in contact withthe pawl 180 until depression of the plunger 140. After release of theplunger 140 and the rearward movement of the plunger, the system is setto move forward another cannula 130 forward from the second opening 128in the second end 124 of the handle 120.

The most proximal cannula 130 (i.e., the protruding cannula) is thengrasped by a user (e.g., a surgeon, and typically with the aid of a toolsuch as forceps) and moved from its position adjacent the second end 114of the trocar 110 towards the first end 112. In the example embodiment,the cannula has a circumferential groove 134 formed in its outer surface136 (FIG. 3) to aid in the grasping of the cannula by the tool.

Once positioned near the first end 112 of the trocar 110, the cannula130 is slid into the incision such that it is positioned between theincision and the trocar. The trocar 110 is then removed from the centralopening 132 of the cannula 130 by sliding the trocar in a direction awayfrom the patient's body. Another surgical implement may then be insertedinto the central opening 132 of the cannula 130 and used in the surgicalprocedure. Examples of such surgical implements include fiber opticlights, lasers, probes, infusion systems, or other surgical tools. Aftercompletion of the surgical procedure the cannula 130 is removed from theincision.

The method can then be repeated to use the system to pierce anotherportion of the patient's body and insert a cannula in the incision.Thus, when the method is repeated the plunger is depressed again to moveanother cannula forward such that it protrudes from the recess in thefirst end of the cannula. This cannula is then placed in the incisionand the trocar is withdrawn from the cannula and another surgicalimplement is inserted into the central opening of the cannula. Themethod can again be repeated until all of the cannulas have beeninserted into incisions in the patient's body.

In some embodiments, the system 100 may be cleaned/reconditioned andreused after the cannulas 130 have been removed from the system. In suchembodiments, a tool is used to disengage the drive member from the pawl180 such that drive member 162 can be moved to its rearward-mostposition. This tool engages the sloped portion 182 of the pawl 180 anddeflects outward to such a degree that the teeth 168 of the drive member162 are able to pass through the pawl without interference. Additionalcannulas 130 can be placed on the trocar 110 and the system 100 can bereused after appropriate cleaning procedures are performed on thesystem.

The systems and methods described herein position multiple cannulas on asingle trocar. The trocar can be used to cut multiple incisions in thepatient's body and insert one of the cannulas into each incision. Thus,the system can be used to cut each of the separate incisions necessaryin a typical surgical procedure and place cannulas therein without theneed to place a cannula on the trocar prior to placement of the cannulain the incisions. This reduces both the amount of time required to cutthe incisions and place the cannulas therein. The cost of the procedureis reduced as well since only one tool is used to cut multiple incisionsand place cannulas in the incisions.

When introducing elements of the present invention or the embodimentsthereof, the articles “a”, “an”, “the” and “said” are intended to meanthat there are one or more of the elements. The terms “comprising”,“including” and “having” are intended to be inclusive and mean thatthere may be additional elements other than the listed elements. The useof terms indicating a particular orientation (e.g., “top”, “bottom”,“side”, etc.) is for convenience of description and does not require anyparticular orientation of the item described.

As various changes could be made in the above constructions and methodswithout departing from the scope of the invention, it is intended thatall matter contained in the above description and shown in theaccompanying figures shall be interpreted as illustrative and not in alimiting sense.

What is claimed is:
 1. A trocar system comprising: a handle having ahollow interior section and a first end and a second end; a drive memberpositioned within the hollow interior section having a first end asecond end, the drive member having teeth and configured for movement ina longitudinal direction; a pawl positioned within the hollow interiorsection, the pawl disposed to selectively engage one of the teeth andprevent rearward movement of the drive member in the longitudinaldirection; a plunger having a first end and a second end, the second endof the plunger disposed to selectively engage one of the teeth to movethe drive member forward in the longitudinal direction; a trocardisposed adjacent the second end of the handle; a cannula having acentral opening for receiving the trocar; and wherein the first end ofthe drive member is disposed relative to the cannula such that forwardmovement of the drive member by the plunger results in forward movementof the cannula in the longitudinal direction.
 2. The system of claim 1wherein multiple cannulas are disposed on the trocar.
 3. The system ofclaim 1 wherein the teeth have a sloped portion.
 4. The system of claim3 wherein the pawl has a sloped portion that is complementary to thesloped portion of the teeth, and wherein the pawl is formed from aresilient material and deflects away from the drive member upon contactwith the sloped portion of one of the teeth to permit the tooth to movethrough the pawl as the plunger moves the drive member forward in thelongitudinal direction.
 5. The system of claim 4 wherein the pawl isdisposed to return to its undeflected position after the tooth has movedfar enough forward in the longitudinal direction such that slopedportion of the tooth is not in contact with the sloped portion of thepawl.
 6. The system of claim 5 wherein the pawl is disposed to engage abackside of the tooth upon attempted rearward movement of the drivemember and wherein the pawl and backside of the tooth are in lockingengagement such that when engaged the pawl cannot be deflected by thebackside of the tooth to permit rearward movement of the drive member.7. The system of claim 3 wherein a portion of the plunger adjacent thesecond end is formed from a resilient material and deflects away fromthe teeth upon contact with the sloped portion of the teeth to permitrearward movement of the plunger with respect to the drive member. 8.The system of claim 1 wherein the second end of plunger is disposed toengage a backside of the tooth upon forward movement of the plunger inthe longitudinal direction to move the drive member forward in thelongitudinal direction.
 9. The system of claim 1 further comprising afirst spring positioned within the hollow interior section of the handleand connected to the plunger to bias the plunger against forwardmovement in the longitudinal direction.
 10. The system of claim 1further comprising a second spring positioned within the hollow interiorsection and connected to the drive member, the second spring biasing thedrive member against forward movement in the longitudinal direction. 11.The system of claim 1 further comprising a tube connecting the drivemember to the cannula, the tube having a first end and a second end, thefirst end connected to the cannula and the second end connected to thefirst end of the drive member.
 12. The system of claim 11 wherein thesecond end of the tube is received within a recess formed in the drivemember adjacent the first end of the drive member.